Microsurgical selective neurotomy in treatment of the focal spastic syndromes of the different etiology.

Object: To estimate the effectiveness of selective peripheral neurotomy (SPN) in the treatment of local botuloresistant spastic disorders.

Methods: 20 SPNs were performed in 18 patients with spastic disorders. In 11 cases we performed SPN of the nervus obturatorius, in 5 - tibialis, in 3 - musculocutaneous, in 1 - radialis. The results of surgical treatment were estimated by the Ashworth scale and GMFM-88. These data was statistically processed.

Results: There was a significant decrease of spasticity in most cases: from 4,02±0,52 points before surgery to 1,86±0,63 points after surgery (p<0,001). In 11 cases we observed significant improvement in motor functions: from 50,7±12,92% before surgery to 54,9±13,6% after surgery (p<0,001).

Conclusion: SPN is an effective procedure which leads to significant reduction of spasticity, improvement in movement range motor functions in patients with spastic disorders.